Question 2769 — maternity health insurance

Summary

Ms. Stéphanie Rist questions the Minister of Solidarity and Health on the decision to put an end to the reimbursement of intra-articular hyarulonic acids (AHIA) by decree of October 12, 2017. The MP recalls that the medicine transparency commission had decided in favor of a classification allowing 15% reimbursement of Hyalgan, an AHIA. She draws the attention of the Minister to the effectiveness of AHIA in the fights against pain in cases of knee osteoarthritis. The scientific literature reports more than 100 references to clinical trials of AHIAs versus placebo or comparators of meta-analyses or systematic reviews in symptomatic knee osteoarthritis, including numerous clinical trials. 14 published meta-analyses, including 11 versus placebo, conclude positively for 9 of them (some moderately) on the effectiveness of AHIA in the gonarthrosis. The state of research appears to make AHIAs the pharmacological therapeutic option with the best benefit/risk ratio in knee osteoarthritis. The alternatives proposed in the previously cited decree, paracetamol and oral NSAIDs, do not seem capable of truly replacing AHIAs. This situation should push patients to resort more to prostheses. This is already the case in many countries, where the socket in charge is more systematically oriented towards prostheses, to the detriment of a real assessment of the patients' situation in terms of benefit/risk ratio, for lack of alternative. It also entails a significant cost for patients, with a risk of social injustice. The MP underlines that the texts mentioned to justify the delisting of AHIA are recommendations with a national vocation formulated to the United States and Great Britain, countries where the treatment of joint disorders is very different from that in France. She would therefore like to know if, in light of these facts, the Minister of Solidarity and Health could reconsider the decision to delist AHIA in order to define, in conjunction with the health professionals concerned, the conditions of use and reimbursement of this useful medication.

Machine translation from French. The official text remains authoritative.

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